Arthritis Types

About this course

Arthritis can severely impact an individual’s life and routine activities, and can also lead to inactivity-associated health conditions, such as obesity, cardiovascular disorders, and diabetes. This course will discuss the different types of arthritis, their treatments, and common management and treatment options.

Learning objectives

• Describe the various types of arthritis
• Describe common symptoms associated with the arthritis types
• Identify modifiable factors to reduce the risk of arthritis
• Review the available management and treatment options for arthritis
• Review fibromyalgia, systemic lupus erythematosus and gout, and their preventative measures and treatment options

Course outline

32 sections · finish in any order across devices

1. 1

   Introduction

   Did you know that about 58.5 million people, around 1 in 4 adults in the United States, have doctor-diagnosed arthritis?1 Arthritis is defined as acute or chronic inflammation of the joints and encompasses various conditions that involve pain, limited movement, and swelling.2,3 Arthritis prevalence

   4 min

2. 2

   What is Arthritis?

   Arthritis is a disease of the joints that affects individuals, especially adults.3 It includes multiple conditions that cause pain and inflammation of the joints, connective tissues, and tissues around the joints.5 Arthritis can be inflammatory or noninflammatory.3

   4 min

3. 3

   Osteoarthritis

   Osteoarthritis (OA) is one of the most common forms of arthritis.6,7 It affects around 7% or 500+ million people worldwide, and was identified as the 15th highest cause of years lived with disabilities (YLDs) in 2019.7 Despite these concerning statistics, osteoarthritis prevalence is neglected, and

   4 min

4. 4

   Symptoms

   Osteoarthritis is characterized by the following symptoms:3,6,8,9

   4 min

5. 5

   Obesity

   Obesity has long been associated with osteoarthritis due to the increased body weight on load-bearing joints, such as the hips and knees.8,9 Obese patients diagnosed with OA have a higher risk of infection, more severe symptoms, and face technical difficulties in total joint replacement surgery.9

   4 min

6. 6

   Aging

   Aging is one of the most common factors associated with osteoarthritis.8,9 The risk of developing OA increases with age. Most often, adults over 65 years of age are diagnosed with OA or radiographic changes in their joints.8,9 Aging affects multiple joint tissues, such as cartilage, subchondral bone

   4 min

7. 7

   Genetics

   All the causes mentioned above, along with mechanical stress, interplay and lead to pro-inflammatory markers and proteases that mediate joint destruction.6 However, the complete mechanism is complex and unknown.6

   4 min

8. 8

   Rheumatoid Arthritis

   Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune disease that affects approximately 1% of people.3,10,11 In this disease, the body’s immune system attacks the healthy cells and causes inflammation in the affected areas.10 The disease initially affects smaller joints and then progress

   4 min

9. 9

   Symptoms

   Rheumatoid arthritis symptoms are more severe than osteoarthritis and are triggered by an autoimmune response to environmental factors.3 Rheumatoid arthritis symptoms also occur in flares when the symptoms worsen, and remission when symptoms resolve or become manageable.10 The following are the comm

   4 min

10. 10

    Genetics

    Genetics plays a critical role in the development and progression of rheumatoid arthritis.10,11,12 Individuals with a family history of RA have a threefold to a ninefold chance of inheriting the disease.13 Moreover, several twin studies have revealed that genetic risk factors determine 50 to 60% of

    4 min

11. 11

    Environmental Factors

    Genetics is not the only risk factor associated with RA; several environmental, behavioral, and lifestyle behaviors also play a major role in RA development.13 Among them, smoking is the strongest and most consistent factor, with a clear dose-response associated with RA.12,13 It is believed that env

    4 min

12. 12

    Gout

    Once called the king of diseases and disease of kings, gout is the most common inflammatory arthritis in adults in the U.S., even more so than rheumatoid arthritis.14,15 It causes swelling of the joints and is extremely painful.16 Initially, it affects the bigger joints, such as the big toe or lower

    4 min

13. 13

    Symptoms

    As stated above, there are times when the symptoms are severe, called flares, that can last for days or weeks followed by a period of remission, when the symptoms resolve for months or years.17 Gout usually affects one joint at a time, aside from the big toe or lower limb; other body parts affected

    4 min

14. 14

    Causes

    Gout is caused by a condition known as hyperuricemia.15,16,17 It is the leading cause of gout and occurs when there is excess uric acid levels in the body.15,16,17 Purines are compounds that are naturally found in the body and the food that is consumed. When the body breaks down purines, it produces

    4 min

15. 15

    Fibromyalgia

    Fibromyalgia is a pain regulation disorder that is characterized by chronic and widespread musculoskeletal pain.18,19 It has a high prevalence rate in the United States, around 6.4%, and is more common among women (7.7% in women and 4.9% in men).18,20 The reason why this disease is more common in wo

    4 min

16. 16

    Symptoms

    The following are some of the common symptoms associated with fibromyalgia18,19,21

    4 min

17. 17

    Genetics

    Many studies have shown a correlation between genes and fibromyalgia.19 For instance, a genome-wide linkage scan study concluded that first-degree relatives had an increased risk of developing the disease.19 Moreover, there is a 50% correlation rate between chronic pain and genetic variants. The two

    4 min

18. 18

    Inflammation and Immune System

    Several studies also support the theory that inflammatory processes in the peripheral tissues, brain, and spinal cord cause fibromyalgia.19 Patients with fibromyalgia experience symptoms like dysesthesia, swelling, fatigue, and cognitive disturbances, which are the result of the release of chemokine

    4 min

19. 19

    Systemic Lupus Erythematosus

    Systemic lupus erythematosus (SLE) is the most common form of lupus and is an autoimmune disease involving multiple systems.22,23 In SLE, the immune system attacks healthy cells and causes inflammation and pain in the affected body parts.23 It has multiple phenotypes and can progress from mild to mu

    4 min

20. 20

    Symptoms

    Lupus can affect any body organ, and symptoms may vary from person to person.23 The following are common symptoms associated with SLE:23

    4 min

21. 21

    Causes

    The exact cause of SLE is unknown, but several environmental, genetic, endocrine, and immunological factors play a significant role in its development.22

    4 min

22. 22

    Non-Pharmacological Options

    Non-pharmacological therapies are suited for individuals with mild symptoms and include the following:3,6

    4 min

23. 23

    Pharmacological Options

    Pharmacological treatment options for OA involve oral and topical drugs and injections.3,6 Remember that OA is associated with the degradation of articular cartilage and bone matrix components.24 Thus, the cartilage matrix degenerations products are highly researched for target drugs.24 This is beca

    4 min

24. 24

    Rheumatoid Arthritis

    Rheumatoid arthritis can be effectively managed and treated with the help of medication and other self-management therapies, with surgery being the last option.10,11 The aim of RA treatment is to reduce joint deformity, reduce joint pain and inflammation, and improve functionality.11 Treatment plans

    4 min

25. 25

    NSAIDs and Corticosteroids

    First-line treatment for RA involves NSAIDs that are targeted toward reducing joint pain and inflammation.11,12 There are more than 20 NSAIDs available on the market for joint treatment, among which aspirin is the oldest, although certain side effects, such as gastric intolerance, tinnitus, and hear

    4 min

26. 26

    Gout

    Treatment plan for gout depends on the causes of gout and the patient’s overall health and symptoms.16 However, the goal of every treatment is the same, such as reducing symptoms and inflammation and preventing future flares.15,16

    4 min

27. 27

    Table 2: Pharmacological options for acute gout flare15,16

    Medication

    4 min

28. 28

    Medication

    Medications for FM involve anti-seizure medicines, antidepressants, and pain-relieving drugs.21 Therapy is initiated using antidepressants, which include tricyclic medications like amitriptyline, selective serotonin reuptake inhibitors (SSRIs), and norepinephrine reuptake inhibitors (SNRIs), includi

    4 min

29. 29

    Antioxidants

    Antioxidants and vitamins are also used for the treatment of FM because of the higher number of harmful free radicals produced in FM.19

    4 min

30. 30

    Table 4: SLE management drugs for different manifestations22

    Condition

    4 min

31. 31

    Preventive Measures

    Unfortunately, there is no way to prevent arthritis. However, there are certain measures that can be taken to control its symptoms or delay its onset.25,26 Every arthritis type has different modifiable risk factors. For instance, by maintaining a healthy weight and diet, the risks of osteoarthritis

    4 min

32. 32

    Conclusion

    Arthritis is a health problem that can have severe systemic repercussions.3 As stated above, there is no cure for arthritis, and only self-management techniques, medications, and exercises are employed to help reduce pain and inflammation.3 The American College of Rheumatology recommends an interpro

    4 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

• Centers for Disease Control and Prevention. National Statistics. Centers for Disease Control and Prevention. Published 2019. https://www.cdc.gov/arthritis/data_statistics/national-statistics.html
• Arthritis. www.hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/conditions-and-diseases/arthritis
• ‌Shayan Senthelal, Thomas MA. Arthritis. Nih.gov. Published November 14, 2018. https://www.ncbi.nlm.nih.gov/books/NBK518992/
• ‌Arthritis Cost Statistics. Published 2019. https://www.cdc.gov/arthritis/data_statistics/cost.htm
• ‌CDC. Arthritis Types. Centers for Disease Control and Prevention. Published 2019. https://www.cdc.gov/arthritis/basics/types.html
• ‌Sen R, Hurley JA. Osteoarthritis. PubMed. Published 2022. https://www.ncbi.nlm.nih.gov/books/NBK482326/#article-26373.s2
• ‌Hunter DJ, March L, Chew M. Osteoarthritis in 2020 and beyond: a Lancet Commission. The Lancet. 2020;0(0). doi:10.1016/S0140-6736(20)32230-3
• ‌Chen D, Shen J, Zhao W, et al. Osteoarthritis: toward a comprehensive understanding of pathological mechanisms. Bone Research. 2017;5(1):1-13. doi:10.1038/boneres.2016.44
• ‌Centers for Disease Control and Prevention. Osteoarthritis (OA). Centers for Disease Control and Prevention. Published July 27, 2020. https://www.cdc.gov/arthritis/basics/osteoarthritis.htm
• ‌Centers for Disease Control and Prevention. Rheumatoid arthritis (RA). centers for disease control and prevention. Published July 27, 2020. https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html
• ‌Karger.com. Published 2020. https://www.karger.com/Article/FullText/493390
• ‌Chauhan K, Jandu JS, Al-Dhahir MA. Rheumatoid Arthritis. PubMed. Published 2022. https://www.ncbi.nlm.nih.gov/books/NBK441999/
• ‌van der Woude D, van der Helm-van Mil AHM. Update on the epidemiology, risk factors, and disease outcomes of rheumatoid arthritis. Best Practice & Research Clinical Rheumatology. 2018;32(2):174-187. doi:10.1016/j.berh.2018.10.005
• ‌Singh JA, Gaffo A. Gout epidemiology and comorbidities. Seminars in Arthritis and Rheumatism. 2020;50(3):S11-S16. doi:10.1016/j.semarthrit.2020.04.008
• ‌Fenando A, Widrich J. Gout. PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK546606/
• ‌NIAMS. Gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Published April 12, 2017. https://www.niams.nih.gov/health-topics/gout
• ‌CDC. Gout | Arthritis | CDC. www.cdc.gov. Published July 27, 2020. https://www.cdc.gov/arthritis/basics/gout.html#:~:text=quality%20of%20life%3F-
• ‌PMC E. Europe PMC. europepmc.org. Accessed January 27, 2023. https://europepmc.org/article/NBK/nbk540974#_article-65391_s3_
• ‌Siracusa R, Paola RD, Cuzzocrea S, Impellizzeri D. Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update. International Journal of Molecular Sciences. 2021;22(8):3891. doi:10.3390/ijms22083891
• ‌Marques AP, Santo A de S do E, Berssaneti AA, Matsutani LA, Yuan SLK. Prevalence of fibromyalgia: literature review update. Revista Brasileira de Reumatologia (English Edition). 2017;57(4):356-363. doi:10.1016/j.rbre.2017.01.005
• ‌Nancy Garrick DD. Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Published April 5, 2017. https://www.niams.nih.gov/health-topics/fibromyalgia#:~:text=Fibromyalgia%20is%20a%20chronic%20(long
• ‌Justiz Vaillant AA, Goyal A, Bansal P, Varacallo M. Lupus Erythematosus. PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK535405/
• ‌CDC. Systemic Lupus Erythematosus (SLE). Centers for Disease Control and Prevention. Published 2019. https://www.cdc.gov/lupus/facts/detailed.html
• Grässel S, Muschter D. Recent advances in the treatment of osteoarthritis. F1000Research. 2020;9(1). doi:10.12688/f1000research.22115.1
• 5 Proven Ways to Manage Arthritis. centers for disease control and prevention. Published 2019. https://www.cdc.gov/arthritis/basics/management.htm
• ‌How to Reduce Your Risk of Arthritis | Arthritis Foundation. www.arthritis.org. https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/reduce-your-risk

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